Clinical nutrition and the role of hospital pharmacist in the management of covid patient

The nutritional status of everyone represents a fundamental element to maintain a good health and it can be related to infectious agents in some disorders. Prevention, diagnosis and treatment of malnutrition should be included in the management of SARS-CoV-2 patients in order to improve both short- and long-term prognosis. In Covid patients the choice of route of administration for nutrition is closely related to respiratory autonomy. In subjects who are not mechanically ventilated or with non-invasive ventilation (NIV), spontaneous oral feeding is strongly indicated, while considering the patient's comorbidity, chewing ability and swallowing. If this is not possible or if it is not possible to meet the appropriate nutritional needs, it is necessary to resort to artificial nutrition (enteral or parenteral). Enteral nutrition (EN) is preferred to parenteral nutrition (PN) because it allows to maintain the trophism of the gastrointestinal tract, involving a lower risk of infectious complications and it is easier to manage. PN is usually used in patients in whom NE is not feasible, insufficient or contraindicated, or in patients with invasive total mechanical ventilation. Based on these considerations, it would be necessary to develop a targeted nutritional pathway in order to support the management of Covid patients. In the nutritional management of these patients, the role of the hospital pharmacists is fundamental. They collaborate with clinicians, nutritionist, dieticians and speech therapists to choose the most appropriate nutrition, based on the clinical characteristics of the patient and on the availability of nutritional formulations in the therapeutic guide.